ABSTRACT
INTRODUCTION: Treatment of recurrent stress incontinence after a failed surgical procedure is more complicated, and repeat surgeries have higher rates of complications and limited efficacy. We determined the technical feasibility, efficacy, adjustability, and safety of adjustable continence therapy device for treatment of moderate to severe recurrent urinary incontinence after failed surgical procedure. MATERIALS AND METHODS: Female patients with moderate to severe recurrent stress urinary incontinence who had at least one prior surgical procedure for incontinence were enrolled. All patients underwent percutaneous placement of adjustable continence therapy (ACT) device (Uromedica, Plymouth, Minnesota). Baseline and regular follow-up tests to determine subjective and objective improvement were performed. RESULTS: A total of 89 patients have undergone implantation with 1-3 years of follow-up. Data are available on 77 patients at 1 year. Of the patients, 47% were dry at 1 year and 92% improved after 1-year follow-up. Stamey score improved from 2.25 to 0.94 at 1 year (P < 0.001). IQOL questionnaire scores improved from 33.9 to 71.6 at 1 year (P < 0.001). UDI scores reduced from 60.7 to 33.3 (P < 0.001) at 1 year. IIQ scores reduced from 57.0 to 21.6 (P < 0.001) at 1 year. Diary incontinence episodes per day improved from 8.1 to 3.9 (P < 0.001) at 1 year. Diary pads used per day improved from 4.3 to 1.9 (P < 0.001). Explantation was required in 21.7% of patients. CONCLUSION: The ACT device is an effective, simple, safe, and minimally invasive treatment for moderate to severe recurrent female stress urinary incontinence after failed surgical treatment.
Subject(s)
Equipment and Supplies , Severity of Illness Index , Urinary Incontinence, Stress/therapy , Adult , Aged , Aged, 80 and over , Equipment and Supplies/adverse effects , Feasibility Studies , Female , Follow-Up Studies , Gynecologic Surgical Procedures , Humans , Middle Aged , Retrospective Studies , Secondary Prevention , Treatment Failure , Treatment Outcome , Urologic Surgical ProceduresABSTRACT
AIMS OF STUDY: Assessment of the Abdominal Global Method (ABDO-MG) in the treatment of stress urinary incontinence or mixed incontinence with stress predominance in women. METHODS: Thirty patients with clinically and urodynamically proven genuine stress incontinence or mixed incontinence with stress predominance were enrolled. Patients had 4 weeks of ABDO-MG technique under supervision and a home unit to do their exercises, then 8 weeks of home exercises without home unit or supervision. We compared the results for each patient before the treatment, at 4 and 12 weeks post initiation of the technique. Main outcome measures were short Pad test with standardized bladder volume and exercises as well as self-report of degrees of incontinence. RESULTS: The data showed improvement in leakage on short Pad test from 82.0 g before versus 38.8 g and 24.8 g at 4 and 12 weeks respectively (p = 0.0002). Seventeen of thirty patients were completely dry. All patients reported improvement of their condition after 4 weeks of exercises and almost cure at 12 weeks (p = 0.0001). CONCLUSIONS: This is the first study demonstrating the clinical efficacy, both objectively and subjectively, of the technique ABDO-MG in the treatment of genuine stress urinary incontinence and mixed incontinence with stress predominance in women. Our data are encouraging, however long-term study with control group is warranted.
